Defining Blood Pressure

It’s 5 p.m. on a Friday in the height of summer. You’re heading—along with what seems like 300,000 others—from your home in the city to a secluded weekend escape. Two miles out from the city, traffic slows to a crawl. There’s no accident, no construction—simply too many cars trying to move on a highway that just can’t accommodate that much traffic. So the pressure builds as you sit in your steaming car, waiting and waiting and waiting.

Much the same thing happens when you have high blood pressure. With every beat of your heart, oxygen-rich blood is pumped throughout the 60,000 miles of blood vessels in your body. Blood pressure describes the force of that blood as it wends its way through your arteries. As long as the walls of your arteries are clean, smooth, and flexible, the blood flows smoothly and your pressure remains low.

Sometimes, though, artery walls become stiff, so they’re unable to contract and expand easily. Or they get clogged with sticky plaque, clots, and other gunk, thus narrowing the space through which blood can flow. Or too much fluid enters them. When any one of these happens, pressure builds inside your blood vessels, and the next thing you know, you’re listening to some white-coated professional reading you the riot act about your diet, exercise, weight, and health.

Like the unexpected traffic jam, there are no warning signs of high blood pressure. If you don’t have regular checkups with your doctor that include blood pressure monitoring, you could walk around for years with dangerously high levels without a clue. No wonder they call hypertension the silent killer.

Make no mistake: Blood pressure can kill. Just as the growing rush-hour tension on the expressway increases the likelihood of an accident, so the growing pressure of blood against arterial muscles increases the risk of serious damage. It could be a clot breaking loose from an artery wall and traveling to your brain, causing a stroke. It could be microscopic damage to the artery walls themselves that eventually leads to plaque buildup and a heart attack. Or it could be long-term damage to the heart itself as it’s forced to pump harder and harder to get blood through narrowed arteries.

Overall, a diagnosis of hypertension means that your risk of heart attack, heart failure, stroke, and kidney disease has just skyrocketed. Consider this: If you’re between 40 and 70, each 20-point increase in systolic blood pressure (the top number) or 10-point rise in diastolic pressure (the bottom number) doubles your risk of any cardiovascular disease.

If you lower those readings to normal levels, you reduce your risk of stroke by 35 to 40 percent, cut your risk of heart attack by 20 to 25 percent, and lower your risk of heart failure by more than 50 percent. Obviously, then, the benefits of following the DASH-Plus Plan and making the recipes in this book the centerpiece of your diet are enormous. Even better—it doesn’t take long to make a difference, as you’ll see.

High Blood Pressure vs. Hypertension

When it comes to weight, there are three main categories: healthy,
overweight, and obese. While many of us are overweight, we are not technically obese. The government officially considers obesity, as determined objectively based on a person’s body mass index, a disease that warrants regular medical care.

Similar ratings apply to blood pressure. A reading of 120/80 mmHg or less is considered healthy. A higher reading signals high blood pressure, and you should be addressing it, just as you would if you were overweight. If your reading is above 140/90, you have hypertension, which needs a doctor’s ongoing monitoring and treatment.